Current guidelines recommend the oral route for endotracheal intubation. The rationale for this recommendation is that nasotracheal intubation is associated with a greater risk for:
a. basilar skull fracture.
b. cervical hyperextension.
c. impaired ability to "mouth" words.
d. sinusitis and infection.
D
Nasotracheal intubation is associated with an increased risk for sinusitis, which may contribute to ventilator-associated infection. Nasal intubation is contraindicated in patients with basilar skull fracture. The procedure is sometimes performed in patients with cervical spine injury; the procedure can be done without hyperextending the neck. Patients with nasotracheal tubes are generally more comfortable and have a greater ability to "mouth words."
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